Key result
LV dilatation fails to independently predict 30-month mortality in HFmrEF.
Why the study?
LV dilatation reflects adverse remodeling in HFmrEF, but its prognostic role remains uncertain.
Does left ventricular dilatation independently predict 30-month mortality in patients with HFmrEF?
Cohort (n=2,154)
Does left ventricular dilatation independently predict 30-month mortality in patients with HFmrEF?
Left ventricular dilatation in HFmrEF is associated with adverse clinical features and worse unadjusted survival, but it does not independently predict 30-month mortality.
LV dilatation should not guide risk stratification in HFmrEF; leaves open its role in adverse remodeling pathways.
Background Left ventricular (LV) dilatation reflects adverse remodeling in heart failure with mildly reduced ejection fraction (HFmrEF), but its prognostic role remains uncertain. Methods In this analysis, 2,154 HFmrEF patients were stratified by LV dilatation. Associations with clinical characteristics, 30-month mortality, and acute decompensation were assessed using Kaplan-Meier survival analysis and Cox regression. Results 13.5% of patients exhibited LV dilatation, which was associated with male sex (p<0.001), ischemic etiology (p<0.001), lower ejection fraction (p<0.001), and higher NT-proBNP levels (p<0.05). Kaplan-Meier analysis showed reduced survival in patients with LV dilatation (log-rank p<0.05). However, in multivariate Cox regression, LV dilatation was not an independent predictor of 30-month mortality (HR 1.10, 95% CI 0.86–1.41, p=0.458). Significant mortality predictors included age (HR 1.04, p<0.001), CKD (HR 1.38, p=0.001), and anemia (HR 2.18, p<0.001). Conclusion LV dilatation in HFmrEF is linked to adverse clinical characteristics and worse unadjusted survival, but it does not independently predict mortality. These findings suggest that LV size alone is an insufficient prognostic marker, reinforcing the need for comprehensive risk stratification in HFmrEF.
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Schupp et al. (2025) conducted a cohort in Heart failure with mildly reduced ejection fraction (HFmrEF) (n=2,154). Left ventricular dilatation vs. No left ventricular dilatation was evaluated on 30-month mortality (HR 1.10, 95% CI 0.86-1.41, p=0.458). Left ventricular dilatation in HFmrEF was not an independent predictor of 30-month mortality (HR 1.10; 95% CI 0.86-1.41; p=0.458).
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